focal deposits of cholesterol and lipids in the INTIMAL WALL of the heart

it is athero

List some age related changes to the heart.

calcified valves
stiffened arteries
valve rigidity
inelasticity

How does an old heart respond to a stress test?

Heart has less increase in HR and longer period of recovery needed

There is a decreased response to stress when we age

What is collateral circulation?

When the veins regenerate around a block. It happens more when we get older. Be aware that a heart issue in a younger person is much more of a problem than in an older person due to decreased collateral circulation

What is the name of the marker of inflammation related to CAD?

C-reactive protein (CRP) is a nonspecific marker of inflammation that is increased in many patients with CAD. Chronic exposure to even minor elevations of CRP can trigger the rupture of plaques and promote the oxidation of LDL cholsterol leading to increased uptake by macrophages in the endotheial lining

How does CAD develop?

slow progressive disease

Who has the highest incidence of CAD?

white middle aged men

Who has earliest onset of CAD?

african americans (b/c of diet)

Who has highest death rate related to CAD?

african american women

List the nonmodifiable risk factors for CAD.

age (older)
gender (men)
ethnicity (white)
genetic predisposition with family history of heart disease

a marker of inflammation that can predict risk of cardiac disease and cardiac events, even in patients with normal lipid values

What is SO interesting about a BNP?

It is a peptide. Elevated indicates presence of heart failure and distinguishes cardiac vs. respiratory cause of dyspnea. INFUSION OF NATRECOR will elevate levels temporarily.

What is difference between ECG and echocardiogram?

ECG records cardiac electrical activity

Echocardiogram - records direction and flow of blood through heart...place patient in supine position on left side facing equipment

What does a cardiac catheterization study do?

obtains information about oxygen saturation and pressure readings within the heart chambers.

How is a cardiac cath done?

inject contrast medium to assist in examining structure and motion of heart. A catheter is either inserted into a vein (for right sided study) or into an artery (for left sided study). Brachial or Femoral vein.

Before a procedure, what are the nursing responsibilities for a cardiac cath procedure?

-obtain permission
-check for iodine sensitivity
-withhold food or fluids for 6-18 hours before procedure
-give sedative
-instruct patient to cough or take deep breath when catheter is inserted
-monitor patient on ECG throughout procedure

What type of sedative might be given to patient prior to cardiac catheterization?

study involves injection of radiopaque contrast medium directly into the coronary arteries. LOOKS AT BLOOD FLOW IN THE HEART VESSEL. It is used to evaluate patency of coronary arteries and collateral circulation.

What type of diet do you tell a CAD or angina patient to follow?

low fat, low sodium

What is laser angiography?

laser that widdles away the plaque

What type of sedative might be given to patient prior to cardiac catheterization?

study involves injection of radiopaque contrast medium directly into the coronary arteries. LOOKS AT BLOOD FLOW IN THE HEART VESSEL. It is used to evaluate patency of coronary arteries and collateral circulation.

What type of diet do you tell a CAD or angina patient to follow?

low fat, low sodium

What is laser angiography?

laser that widdles away the plaque

What is CABG?

bypass the occlusion

What is PTCA?

percutaneous translumina coronary angioplasty

(with or without stent placement)

pushes back the plaque

What is preload vs afterload?

preload is amount of blood in the heart AT REST

afterload is the PERIPHERAL RESISTANCE the heart must pump against

When you thinkcalcium channel blocker, you should think....

calcium channel blocker VASODILATION

Beta blockers reduce both....

heart rate and contractility

decrease afterload

What type of drug is famous for causing a 50% reduction in progression of CAD to an MI?

aspirin (antiplatelet agents)

When should antiplatelet drugs be administered?

should be administered as soon as ACS is suspected

Other than aspirin, what other drug is an antiplatelet?

plavix...it inhibits platelet aggregation and is an alternative for a patient that can not take aspirin

When singing the ABCs of chronic stable angina treatment, what is next after aspirin?